Health Policy for Aboriginal Children Respiratory Illness

This report discusses the development of a health policy by the Lung Foundation Australia to address respiratory illness among Aboriginal children. It highlights the prevalence of respiratory diseases in this population and the factors contributing to it. The report also provides recommendations for prevention funding, training of healthcare professionals, and community partnerships to mitigate the occurrence of respiratory illness.

Running head: HEALTH POLICY
Health Policy
Name of the Student
Name of the University
Author Note

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Introduction
Policies for the advocacies are different from public policies and are developed by
certain organisation. In this report we have chosen Lung foundation, Australia. The report
will be written on behalf of Lung foundation, Australia, advocating on the incidence of
respiratory illness in children of aboriginal and Torres Strait Islander community. The report
will give a background information about the organisation followed by the health issue
prevalent among the children. Finally the advocacy policy will be concluded by three
recommendations for the government to mitigate the occurrence of respiratory illness among
the aboriginal and the Torres Strait Islanders (Hall et al. 2016).
Respiratory illness are the major causes of poor health among the Aboriginal and the
Torres Strait Islander people and children are the most vulnerable group to respiratory
diseases (Zar and Ferkol 2014). Respiratory illness refers to a large number of lung condition
that affects the lung and its constituents.
Health issue / problem
In Australia, the health related problem among the Indigenous children are very
severe and they are more vulnerable for developing any disease while comparing with the
non-Indigenous Australians. Among the Aboriginals and Torres Strait Islander people, it is
observed that, due to the lower socio economic condition, they are facing issues related to
homelessness which is one of the reason of having lung related problem among that
population (Singleton et al., 2014). The problem of the lung related disease is common
among the children between 0-14 years.
Respiratory disease covers a wide variety of lung diseases and it is reported that,
respiratory diseases are one of the primary causes of poor health among Indigenous people in
Australia. Pneumonia has been found to be the predominant cause of most of the respiratory

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illness. Tuberculosis is another respiratory illness that is prevalent among the aboriginal
children. Tuberculosis can be related to overcrowd housing in the aboriginal communities,
leading to the spread of communicable diseases (Carrière, Garner and Sanmartin, 2017).
Therefore, it is observed that, the 1/5th of the Indigenous children were suffering from
respiratory diseases and rate of hospitalization due to respiratory problems are also very high
(Australian government, Department of Health. 2017). It was documented that, due to
asthma, upper and lower respiratory conditions, 2 times more number of Indigenous children
are affected while comparing with the non-Indigenous people (Singleton et al., 2014). In
addition to this, it is reported that, the traditional believes are also responsible for more this
higher disease rate among the Indigenous people. The higher prevalence of respiratory
disease is a cumulative effects of various factors such as socioeconomic, environmental,
genetic and demographic factors of that population. The report of Australian Government
showed that among the children, lower respiratory tract infections (LRTI) is one of the major
cause of mortality around the world. In an Australian study with 180 subject population, it is
reported that, 33% of the total sample population had acute respiratory diseases and among
the total sample population 22% had a visit to the health care centre due to respiratory
problems (O’Grady et al., 2018). In another study, it was reported that 39% of subject
population (n=561) had the problem of coughing that is a symptom of respiratory disease
(O’Grady et al., 2018). The hospitalization rate was also high among the Indigenous
population while comparing with the non-Indigenous population (Chang et al., 2014).
Respiratory disease both chronic and acute is the major cause of the Islander children. This
burden is especially high on those who live in an environment of socio-economic
advantages .The life of the aboriginal people, including the children has been fragmented due
to the impact of colonisation. The traditional life of the people who used to live with well-
established laws, languages, religions, dresses, life views were severely affected. Negative

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health outcomes related to respiratory diseases among the aboriginal population are due to the
presence of inadequate housing, poor education, and employment, unequal access to the
primary care services, malnutrition, low physical activity, smoking and more (O’Grady et
al.2018). Socioeconomic status is another factor that might contribute to the growing burden
of disease. The burden of disease has further been found to be high among the people living
in the rural areas mainly in the Northern Territory, Western Australia (O’Grady et al.2018).
In a study conducted by the aboriginals and the Torres Strait Islander children has indicated
towards some of the predisposing factors for the development of respiratory illness among
the children, those are neglect by the parents, lack of family support, inadequate
communication and absence of trust upon the healthcare professionals, loss of cultural beliefs
and values, hereditary factor and poverty. Again Zar and Ferkol (2014) have stated that adult
respiratory illness can have direct negative impact on the health of the child. Children living
in households with an adult having COPD increases the chance of Pneumonia in children.
Again an adult household tuberculosis contact is an important predisposing factor for the
transmission to infants. Again, a child staying in an HIV infested household have an
increased risk of respiratory disease (Al-Yaman 2017). Children suffering from respiratory
illness faces more absenteeism, increased of other types of chronic diseases, psychological
and the economic burden due to an increased rate of hospital admission (Bell 2015).
Background
The organisation that has been chosen to develop a policy is the Lung foundation in
Australia. In Australia, the Lung Foundation Australia (LFA) is working with the lung related
problems. LFA is a government funded organization associated with securing patient
advocacy among the respiratory disease patients. LFA conducts all kind of lung related
researches to offer the maximum care to the patients of Australia. There are responsible for
developing the policies that addresses the air quality, asthma, COPD, lung cancer and tobacco

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control help to prevent and manage lung diseases. With the excellent advocacy team, the
organisation works for enacting changes to reduce children respiratory illness, manage
children with the asthma. The primary aim of this organization is to secure good condition of
lungs and simultaneously they are also encouraging early detection of lung diseases.
Moreover LFA also arranges training program for the health care providers so that they can
easily deliver care to the patients (Lung Foundation Australia, 2019). The LFA also adopts
policies and practices that addresses the air quality index of the remote places, chronic lung
diseases, asthma. The organisation also works with the schools to equip them to handle
asthma and other respiratory emergencies. They are also found to have been working with the
public health partners. They also conduct health impact assessment for getting an
environmental pollution taking place for any construction.
Policy for advocacy
The key focus for the advocacy is to ensure that the lung diseases gets the level of
policy and research support required to reduce the burden and the impact of the disease. A
policy will be drafted by the Lung foundation in Australia, aiming to improve the respiratory
health of the Aboriginal children.
Some of the other objectives for the policy for advocacy would be:
 Early detection of the respiratory disease in children
 Provision of ample facilities in the primary health care setting in order to fight with
the disease (Gibson et al. 2016).
 Establishing a proper model of care to support and improve the lung health care
 To work in partnership with the community to mitigate he respiratory illness among
the aboriginal children.

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 Provision of proper health education to the aboriginal community for combating with
respiratory illness.
 To lobby for increasing the funding for the prevention of respiratory illness among
children.
The rationale for these objectives is that there is an absence of definite risk assessment tools
for the aboriginal and the Torres Strait Islander people. Hence, it is necessary to detect he
earliest symptoms like cough and cold among the children, which might reflect an underlying
serious disorder (Al-Yaman 2017). Using suitable cough pathways or the algorithm is one
approach that can lead to an earlier diagnosis of the underlying pathophysiology of chronic
illness and thus can reduce the morbidity due to chronic cough and high health care costs.
Again a randomised control trial by Chang et al. (2017) have proved that a follow up of a
child in the primary clinic after a post lung hospitalisation is necessary for determining the
resolution of the lung signs and symptoms. In order to do that, the primary health care clinics
should have appropriate equipment and devices for the screening of the airways of children.
Furthermore, it has been found that lack of health literacy among the aboriginal community is
another risk factor for the respiratory illness and spread of the diseases. The aboriginal people
needs to be educated about the various preventive measures like immunisation against
influenza (Lovie-Toon et al. 2016). Additionally, it is necessary that the state government and
the federal government should also review the range of policies. Again, an organisation
should have a strong connection with the politicians and the government to convey the
grievances to the government.

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Recommendations
It has already been stated that the Lung foundation in Australia plays an important
role to lobby issues in front of the government, like lobbying about the funding issues for
addressing the respiratory health of the Aboriginal children (McDonald, Bailie and Morris
2014). Government plays an important role for addressing such serious issues by providing
suitable funding or mass awareness or setting up of campaigns throughout the territory.
Some of the useful recommendations for the government can be –
Prevention funding for the children- The government should invest more in the
community based prevention initiative of the respiratory illness, including childhood
immunizations, clinical prevention and tobacco use prevention programs (Ward, Fredericks
and Best 2014). There had been evidences, where investments had decreased the rate of
smoking among the adolescent population. Government can also liaise with the NGOs to the
set up sustainable prevention programs. The mandatory public health insurance scheme
should be revised. Insurance facilities can be given to the aboriginal population free of cost
(Ferkol and Schraufnagel 2014). The primary health care clinics should contains the basic
equipment like spirometer to assess the lung health. The funding for the primary health care
in Australia should be increased as primary health are the first line of contact in the
Australian health care system (Dixit and Sambasivan 2018). Furthermore, in the remote areas
of the aboriginal community there are only primary health care services which they can get
access to. Hence, government should increase the funding to improve the primary health care
services. The primary health care systems can keep the people well and out of the hospitals, if
enough support like initial screening of the disease can be conducted in the primary health
care services (Agarwal et al. 2017). Providing health care close to the home is always
effective.

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Another important recommendation for the government can take initiatives to train
the primary health care professionals for detecting respiratory disease and using appropriate
strategies to manage them. Establishing specific models of care, such as the provision of one
on one health literacy to the adult caregivers of the children suffering from acute chronic lung
disease. The primary health care providers should be trained enough for a proper assessment
of the clinical condition and to suggest some preliminary measures. Aboriginal health care
professionals should be recruited in the primary health care facilities in the aboriginal clinic
in order to provide a cultural safe care.
The government can work in partnership with the local community to mitigate the
cases of aboriginal community. Government funded community based health literacy
programs and services can be helpful to work on this issue. Individualised and
multidisciplinary case management functioning within an interproffessional framework is
optimum (Gomersall et al. 2016). Special outreach programs funded by the aboriginal unit of
Australian health department can be initiated. Special teams can be allocated to different
areas of service. Quarterly specialise paediatric respiratory clinic can be temporarily opened
in some remote areas. Mobile clinics can be set up in the aboriginal community and specific
programs of immunisation, targeting respiratory infections can be set up or an extra dose of
pneumococcal vaccine for children between 12 and 18 months can be organised (O’Grady et
al. 2016). Some of the National initiatives like specific immunisation programs, programs to
reduce the exposure to tobacco smoke and funding of some of the important research , that
has already been taken should be reviewed and revised to provide an equal access to health
care for the aboriginal and the Torres strait Islander community.
Conclusion
Respiratory problems in the aboriginals and the Torres Strait Islander is a serious
problem and its advancement in to chronic lung problems should be made immediately

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preventable. The burden of the disease in the children receives scant attention than adult lung
disease. In order to mitigate the disease burden of the of the respiratory disease among the
aboriginal children, best practice medicine is required in addition to the improvement in the
socioeconomic factors , decreasing the harmful exposures. This would also address the access
to the health care, that is culturally acceptable and illness preventive programs contributing to
the disease. Increasing the funding for improving the primary health care service and the
other health literacy programs, immunisation campaigns can be helpful for improving the
lung health of the children.

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References
Agarwal, R., Green, R., Agarwal, N. and Randhawa, K., 2016. Benchmarking management
practices in Australian public healthcare. Journal of health organization and management,
30(1), pp.31-56.
Al-Yaman, F., 2017. The Australian Burden of Disease Study: impact and causes of illness
and death in Aboriginal and Torres Strait Islander people, 2011. Public Health Res Pract,
27(4), p.e2741732.
Arshad, A., Salam, R.A., Lassi, Z.S., Das, J.K., Naqvi, I. and Bhutta, Z.A., 2014. Community
based interventions for the prevention and control of tuberculosis. Infectious diseases of
poverty, 3(1), p.27.
Australian government, Department of Health. 2017. Fact Sheet: Primary Health Care.
Access date: 18.5.2019. Retrieved from:
https://www.health.gov.au/internet/main/publishing.nsf/Content/Fact-Sheet-Primary-Health-
Care
Bell, A., 2015. Respiratory illness in urban Indigenous children: risk and cultural context.
Carrière, G.M., Garner, R. and Sanmartin, C., 2017. Housing conditions and respiratory
hospitalizations among First Nations people in Canada. Health reports, 28(4), p.9.
Chang, A. B., Brown, N., Toombs, M., Marsh, R. L., & Redding, G. J. (2014). Lung disease
in indigenous children. Paediatric Respiratory Reviews, 15(4), 325-332.
Chang, A.B., Brown, N., Toombs, M., Marsh, R.L. and Redding, G.J., 2014. Lung disease in
indigenous children. Paediatric Respiratory Reviews, 15(4), pp.325-332.

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Dixit, S. K., and Sambasivan, M. 2018. A review of the Australian healthcare system: A
policy perspective. SAGE open medicine, 6, 2050312118769211.
Ferkol, T. and Schraufnagel, D., 2014. The global burden of respiratory disease. Annals of
the American Thoracic Society, 11(3), pp.404-406.
Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., Riitano, D., McBride,
K. and Brown, A., 2015. Enablers and barriers to the implementation of primary health care
interventions for Indigenous people with chronic diseases: a systematic review.
Implementation Science, 10(1), p.71.
Gomersall, J.S., Canuto, K., Aromataris, E., Braunack‐Mayer, A. and Brown, A., 2016.
Systematic review to inform prevention and management of chronic disease for Indigenous
Australians: overview and priorities. Australian and New Zealand journal of public health,
40(1), pp.22-29.
Hall, K.K., Chang, A.B., Anderson, J., Dunbar, M., Arnold, D. and O'grady, K.A.F., 2017.
Characteristics and respiratory risk profile of children aged less than 5 years presenting to an
urban, Aboriginal‐friendly, comprehensive primary health practice in Australia. Journal of
paediatrics and child health, 53(7), pp.636-643.
Lovie-Toon, Y.G., Hall, K.K., Chang, A.B., Anderson, J. and O’Grady, K.A.F., 2016.
Immunisation timeliness in a cohort of urban Aboriginal and Torres Strait Islander children.
BMC public health, 16(1), p.1159.
Lung Foundation Australia (2019). Who we are | Lung Foundation Australia. [online] Lung
Foundation Australia. Available at: https://lungfoundation.com.au/about/who-we-are/
[Accessed 12 May 2019].

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McDonald, E.L., Bailie, R.S. and Morris, P.S., 2014. Participatory systems approach to health
improvement in Australian Aboriginal children. Health promotion international, 32(1),
pp.62-72.
O’Grady, K.A.F., Hall, K.K., Sloots, T.P., Anderson, J. and Chang, A.B., 2017. Upper airway
viruses and bacteria in urban Aboriginal and Torres Strait Islander children in Brisbane,
Australia: a cross-sectional study. BMC infectious diseases, 17(1), p.245.
O’Grady, K.F., Hall, K.K. , Bell , A. , Chang, A.,B., & Potter, C. ( 2018). Review of
respiratory diseases among Aboriginal and Torres Strait Islander children. Australian
Indigenous HealthBulletin 18(2).
Singleton, R. J., Valery, P. C., Morris, P., Byrnes, C. A., Grimwood, K., Redding, G., ... &
Holman, R. C. (2014). Indigenous children from three countries with non‐cystic fibrosis
chronic suppurative lung disease/bronchiectasis. Pediatric pulmonology, 49(2), 189-200.
Ward, R., Fredericks, B. and Best, O., 2014. Community controlled health services: What
they are and how they work. Yatdjuligin: Aboriginal and Torres Strait Islander Nursing and
Midwifery Care, pp.87-101.
Zar, H.J. and Ferkol, T.W., 2014. The global burden of respiratory disease—impact on child
health. Pediatric pulmonology, 49(5), pp.430-434.